Make a Donation

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Select an Amount.

Amount
Select the dollar amount you wish to contribute.

Send Organization a Message.

Nickname/Name
Nickname/Name to be be sent to "Canaberra Swim-A-Thon 2015" .

Message OPTIONAL

This message will NOT be shown publically. It will be sent directly to "Canaberra Swim-A-Thon 2015".

Request Charitable Receipt.

Fill out the form below if you would like to receive a charitable receipt.

I would like to receive a charitable receipt
You must check the box above if you would like to receive a charitable receipt

Would you like to receive more about this organization?

Terms and Conditions:

I have read and agree to the Terms and Conditions.
You must check the box above to indicate that you have read the terms and agree.

Contact Information
ALL FIELDS REQUIRED.
Name:
Enter your full name above.
Address:
Enter your physical mailing address.
City:
Province/State:
Postal Code/Zip Code:
Country:
Phone Number:
Enter your telephone number. Be sure to include the area code.

Email Address
Your charitable receipt will be delivered to this email address.

Confirm Email Address
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Email Address
A thank you email will be send to this email address.

Confirm Email Address
Please confirm your email address.